Another update about my brother

elainechem

I went with my older brother this morning to see the neuropsychologist who tested him three weeks ago. She diagnosed him with mild cognitive impairment. She wants to see him again in a year to repeat the testing. If he has declined in that time, she will likely diagnose Alzheimer's. His short-term memory is so poor, I'm surprised that he can still function independently. But, he has a very high IQ and that enables him to compensate for many of his deficits. She predicts that he will progress to Alzheimer's because his MCI is the amnestic type and that's what usually happens in that case.

He, of course, disagrees with almost everything she said. He argued that pretty much nothing has changed for him in 30 years. Of course, I knew him 30 years ago and he wasn't like this. It's pointless to argue with him though. Like most people with dementia, he has anosognosia. He is unable to see what's really going on. My hubby was also like this, so I'm used to it.

It's a six hour drive to his place. I'm getting used to that too. I'll try to visit him every three months or so if I can. If something catastrophic happens, I'll have to take legal measures to become his guardian.

In the meantime, he has an appointment with his PCP next week. The neuro wants him tested for the APOE-4 gene. If he has it, then there's a good chance that I do as well. I'm not afraid. It is what it is, but God is with me and he is always faithful.

She also told him to ask about Leqembi. And she recommended that he start on an internet program to work on improving his cognition. I doubt if he'll remember to do that. I'm also doubtful that such a thing would have much impact anyway. Once the decline has started, there isn't much you can do to change the trajectory.

She advised him not to drive after dark because it would be less likely that he would get lost. No, she doesn't think that his driving privileges should be suspended at this point. I let him drive me around a lot over the past few days. I thought that he did okay. He wasn't taking unnecessary risks and he was obeying the traffic laws.

M1

They nearly always say MCI on the first visit, almost like they’re afraid to use the “A” word.

So he’s by himself most of the time? Sounds worrisome. If you don’t already have power of attorney I’d take steps to get it now while he can still sign. And make contingency plans for moving him closer to you eventually. You should probably also see about getting him Medicaid qualified if needed, though I guess that could be problematic since you’re in NM and he’s in CO.

I’m sorry you’re facing this a second time.

elainechem

https://alzconnected.org/discussion/comment/220787#Comment_220787

He is working on getting his POAs in order. He is determined to name his very pregnant stepdaughter, who lives in Florida, as his primary for both. Then he names our brother, who lives in Europe, as second. Thirdly, he named his best friend who, at least, lives close to him. I have to talk to the best friend to see if he would be willing and able to serve in this capacity. If not, I can always sue for guardianship.

And he won't qualify for Medicaid due to his income and assets. He would be self-pay in a facility.

elainechem

Today, my brother sent me a photo of the current draft of his medical POA. This time, he lists his stepdaughter as his primary, her husband as secondary, and me as the third choice. Apparently, he still hasn't signed it yet. I wonder how many times he will change his mind before he signs it (if he ever signs it,)?

elainechem

I live a six hour drive from him. I can’t go there all the time to go with him to appointments. He did inadvertently give me the name of his lawyer's office. I may give them a call and inform them that he has a cognitive impairment.